Remodeling after lateral closing-wedge osteotomy in children with cubitus varus

Abstract

The purpose of this study was to evaluate the effectiveness of supracondylar lateral closing-wedge osteotomy of the humerus in children and the postoperative remodeling of the lateral condylar prominence. Lateral closing-wedge osteotomy for cubitus varus deformity was performed in 52 children. In all cases, medial translation for decreasing lateral condylar prominence or transposition of the ulnar nerve was not performed. Mean patient age was 8.8 years. Mean follow-up was 42 months. Clinical and radiological results were analyzed at last follow-up. Mean range of motion of the elbow in flexion and extension improved significantly (P<.05). Mean humeroulnar angle and mean shaft-condylar angle were significantly corrected (P<.05), and the angles between the affected and contralateral sides were not significantly different at last follow-up. Mean lateral condylar prominence index significantly decreased from 38.8% to 3.4%, and mean lateral condylar prominence amount decreased from -31.6% to -65.0% (P<.05 and P<.05, respectively). The amount of lateral condylar prominence remodeling was statistically correlated with the severity of preoperative cubitus varus, length of follow-up, and age at operation (P<.05 for all). The mean change in lateral condylar prominence amount in patients younger than 11 years (36.6%) was significantly greater than the mean change in lateral condylar prominence amount in patients aged 12 years or older (20.4%) (P=.001). Supracondylar lateral closing wedge osteotomy of the humerus is a simple and effective operation for correction of cubitus varus in children younger than 11 years with a considerable amount of lateral condylar prominence remodeling.